The level of sedation depends on the patient’s symptoms. In the case of light sedation, the patient is sleepy but can be roused when talked to. In deeper sedation, the patient is continuously asleep. The purpose of palliative sedation is not to impact the patient’s life expectancy.
Palliative sedation
Sedation means lowering the patient’s consciousness with medications, bringing the patient to a state of sedation or light sleep. In hospice care, sedation may be used as a temporary intervention or, as death draws closer, as a continuous measure up until death.
Sedation may be initiated if the patient is suffering from an unbearable symptom that persists even after all measures available have been taken. Some of the most common examples include severe shortness of breath, restlessness or mental anguish, and sometimes pain or nausea. In rare cases, sedation is called for because of acute situations such as bleeding.
Before sedation is initiated, all possible measures are taken to relieve the patient’s symptoms. The prospect of starting the sedation is discussed with the patient and their loved ones. If the patient is no longer able to give consent regarding their treatment, the doctor makes the treatment decision after consulting the patient’s loved ones on what the patient most likely would have wanted.
The duration of sedation depends on the patient’s needs. Sometimes sedation is only needed for a little while – for example, overnight, to help the patient get through a rough spell with the aid of medication. Sedation can also last for a few days, after which the treatment continues with other types of symptom-relieving medication. Alternatively, the patient may be sedated for the last few days of life and remain sedated until death.
Sedation until death is applicable when the patient is near death (life expectancy is measured in days). In such cases, the purpose of sedation is to enable the patient to die a peaceful natural death caused by their illness. In other words, sedation does not mean euthanasia, since the medication given to the patient is not meant to cause death.
During sedation, the patient is administered pain medications and other appropriate types of symptom-relieving medications as before. Likewise, the patient’s symptoms are monitored closely, and their basic needs are attended to with loving care. The patient’s loved ones are cared for as well. If the patient previously experienced severe symptoms, the decision to initiate palliative sedation may be a relief for their loved ones. At the same time, a great deal of grief related to loss may be involved, as the situation stabilises and gives those involved room to grieve.
Updated 31.3.2025